A hybrid approach to salvage a failing long-standing autogenous aneurysmal fistula in a hemodialysis patient

Int J Artif Organs. 2010 Nov;33(11):819-23.

Abstract

Very few studies have addressed the repair of autogenous and prosthetic-related false arteriovenous access (AVA) aneurysms in hemodialysis patients. Surgical management of complicated AVA-related aneurysms remains the gold standard method although covered stents have recently been introduced for the exclusion of such aneurysms, offering a minimally invasive therapy. In this paper, we describe a combination of open and endovascular repair for treating an anastomotic and a puncture-site aneurysm to salvage a failing long-standing autogenous radial-cephalic fistula in the wrist. Resection of the anastomotic aneurysm and reconstruction of the anastomosis proximally was initially performed. Via the first cm of the anastomosis, a Fluency® stent graft (SG) was inserted and it successfully excluded the mid-outflow vein false aneurysm. Such hybrid therapies may be the future of AVA revisions and this trend should not be overlooked by nephrologists and vascular surgeons.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / physiopathology
  • Aneurysm, False / surgery
  • Aneurysm, False / therapy*
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Combined Modality Therapy
  • Endovascular Procedures* / instrumentation
  • Humans
  • Ligation
  • Male
  • Middle Aged
  • Prosthesis Design
  • Radiography
  • Renal Dialysis*
  • Reoperation
  • Salvage Therapy
  • Stents
  • Time Factors
  • Treatment Outcome
  • Vascular Patency
  • Wrist / blood supply*